Human papilloma
virus (HPV)

Human papilloma virus (or HPV) affects the skin and the mucosa. The mucosa is the moist membrane that lines the inside of certain body parts. For example the mouth, throat and anus.

It’s very common and over 100 different types of HPV have been identified.

Some types of HPV can increase the risk of developing cancer. These are called high-risk HPVs. But it’s important to note that most people with HPV will not develop cancer.

HPV is spread through skin contact, often during sex. Using a barrier form of contraception can reduce your risk of becoming infected. For most people, HPV infections come and go without any symptoms. Sometimes, the virus may remain inactive for months after infection.

HPV is associated with:

cervical cancer

vulval cancer

vaginal cancer

anal cancer

head and neck cancers

penis cancer.

There isn’t a standard test for HPV routinely offered for both men and women. HPV can’t be diagnosed by having a blood test. HPV infection of the cervix may be diagnosed in women as a result of the cervical screening programme. If you’re worried about HPV and cancer speak with your GP.

HPV and the risk of cancer

The human papilloma virus (HPV) is a common group of viruses. Over 100 different types of HPV have been identified, and each is known by a number. HPV affects the skin and the mucosa (the moist membranes that line parts of the body, such as the insides of the mouth, throat and anus).

Some types of HPV are known to increase the risk of developing particular types of cancer and are known as high-risk HPVs. The types most often associated with cancer are types 16 and 18. High-risk HPVs can lead to abnormal changes in the cells, which is sometimes called dysplasia. Although dysplasia is not cancer, it's sometimes described as being pre-cancerous.

Other types of HPV can cause warts and verrucas. These may appear on different parts of the body, but are more commonly seen on the hands and feet, in the genital area and around the anus. The types of HPV that cause visible warts and verrucas are less clearly linked with cell changes that can increase the risk of cancer. They are known as low-risk HPVs.

This information is about the high-risk HPV types that can increase the risk of developing cancer.

How HPV is spread

There are around 40 different types of HPV that can affect the anogenital area (the cervix, vulva, anal area and penis). HPV is spread through skin contact, often during sex. Exactly how a person gets the virus is uncertain, and it's not always possible to find a sexual cause. It's thought there may be other ways of spreading the virus that have not yet been identified.

HPV can affect both men and women and because the virus is very common, most people who are sexually active will have HPV at some time during their life. Many people don’t have any symptoms and are unaware that they have HPV. The virus may be inactive for weeks, months, and - for some people - possibly even years after infection. The body’s immune system is usually able to get rid of an HPV infection, and for most people infections come and go without causing any problems.

Although HPV can increase the risk of developing some types of cancer, most people who have HPV won't develop cancer.

Reducing the risk of HPV infection

If you are sexually active it may be difficult to avoid becoming infected with HPV.

As most high-risk HPVs don't cause symptoms, it can be impossible to tell whether your partner is infected. Using condoms and other barrier methods of contraception can help reduce the risk of becoming infected. But they don't cover all of the skin and are therefore not completely effective.

You're more likely to become infected with HPV if you start having sex at a younger age and if you have a lot of sexual partners, especially if you’re having sex without using a barrier method of contraception.

HPV infection may be more likely if there are abrasions or small cuts and tears in the skin or mucosa. Abrasions and tears are more likely to occur during anal sex, or if the vagina is drier than normal (for example following the menopause). In these situations it can help to use a lubricant during sex, such as Senselle®, Astroglide®, Sylk®, Vielle® or the range produced by Durex®.

As HPV infection is common (and difficult to prevent), it's important for people to be alert to any changes in the parts of the body where we know HPV may cause cancer. Cancer diagnosed in the very early stages, before it has begun to spread, is much easier to treat and cure. It's important that women have regular cervical smear tests, as these can pick up changes in the cervix at a very early stage.

There is some evidence to suggest that people who smoke and have HPV are more likely to develop cell changes that can lead to cancer than non-smokers who have HPV. If you know you have HPV, or even if you don’t know, stopping smoking may help to boost your immune system.

HPV vaccines

Two vaccines have been produced to prevent HPV. These are called Gardasil® and Cervarix®. It's hoped that these vaccines will prevent at least 7 in 10 (70%) of the most common type of cervical cancer (squamous cell). But HPV vaccinations won't replace the need for regular cervical screening tests in women.

Any vaccine works best if it's given to children before they reach puberty. As the HPV virus is passed on during sex, the vaccine is most effective if it's given to girls before they might start having sex. Girls aged 12–13 are now routinely offered the HPV vaccine Gardasil. Gardasil protects against two of the most important types of HPV (HPV 16 and 18) that can cause cervical cancer. It's also effective against the types of HPV that can cause genital warts.

We have fact sheets that explain HPV and cancer, and HPV vaccines, in more detail.

How HPV is diagnosed

As there are usually no symptoms of high-risk HPV, the infection is often not diagnosed. There are no blood tests to detect HPV.

Diagnosis of HPV in women

HPV infection of the cervix is mainly diagnosed in women as a result of the cervical screening programme. A woman may be told she has HPV when she receives her cervical screening result.

If an HPV infection is present, changes in the appearance of the cells can sometimes be seen when they are looked at under a microscope during the screening process.

Testing of cervical screening samples for high-risk types of HPV is now being introduced in some areas of the country. This means that if you live in an area where it has been introduced, your cervical screening sample may be tested to see if it contains a high-risk type of HPV. This is explained in more detail in our information about cervical screening. You can also find out more at www.cancerscreening.nhs.uk

Some women who have an abnormal smear test result will attend a colposcopy clinic, where their cervix will be examined using an instrument like a microscope (called a colposcope). During the examination, the nurse or doctor can apply a solution to the cervix that makes cells infected with HPV turn white.

An HPV DNA test can sometimes be done using cells collected during a routine cervical screening test or colposcopy. This test can also be done during an anal smear – see below. The HPV DNA test looks at the genetic make-up (DNA) of the HPV within the cells and can detect which type of HPV is present. This can be useful, as it may help identify whether the HPV is a type that may cause pre-cancerous changes. HPV DNA tests aren't widely available in the UK.

Diagnosis of HPV in men

In men, high-risk HPVs don't cause symptoms and are often very difficult to diagnose.

Some people who are known to be at a high risk of having anal HPV and of developing anal cancer may be offered an anal smear. Men who have anal sex are more likely to have anal HPV and are at an increased risk of developing anal cancer. The risk for men and women with HIV is greater still, regardless of their sexual orientation.

The anal smear is very similar to a cervical smear, and involves collecting cells from the anal area using a special wipe. An HPV DNA test (see above) can also sometimes be done during an anal smear. However, anal smears are not widely available in the UK. If you are in a high-risk group and more likely to have anal HPV, you can talk to your GP or a doctor at your local sexual health clinic, about whether you should have regular anal smears.

Your feelings

Many people feel concerned when they are first told that they have HPV, and worry that they may develop cancer. You may find the treatments embarrassing, and you may have many different emotions, including anxiety and fear. These are all normal reactions and are part of the process many people go through in trying to come to terms with their condition.

Everyone has their own way of coping with difficult situations. Some people find it helpful to talk to family or friends, while others prefer to seek help from people outside their situation. Others may prefer to keep their feelings to themselves. There is no right or wrong way of coping, but help is available if you need it. You may wish to contact our cancer support specialists for information about counselling in your area.

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Whether it is you or someone close to you who has been diagnosed with cancer, you’re likely to experience many emotions. Sharing your feelings can help you and others in your situation. Talk about it here.

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